Diagnostic accuracy of the nasal obstruction index in detecting adenoid hypertrophy in children without allergy

Torretta, Sara; Marchisio, Paola; Esposito, Susanna; Cappadona, Maurizio; Fattizzo, Miriam

doi:10.1016/j.ijporl.2010.10.007

Cited by 19 publications

(19 citation statements)

References 14 publications

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“…Despite some differences related to age, gender and geography, the data indicate that the majority of the respondents use NFE in their pediatric clinical practice and have a generally positive attitude towards it because nearly 70 % defined it as “a generally well-tolerated, minimally invasive examination that can be used in most children; very useful in clinical practice”. As NFE has only recently been considered the preferred means of diagnosing adenoidal hypertrophy in children [ 5 – 7 ], it is not surprising that younger otolaryngologists use it more frequently than those aged >50 years.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the most widely used clinical scores aimed of predicting the severity of nasal obstruction [ 9 , 10 ] is the nasal obstruction index (NOI), which is based on the proportion of oral breathing and speech hyponasality [ 10 ]. This was proposed by Paradise as a reliable and reasonably valid means of detecting the presence and degree of adenoidal hypertrophy in 1998 [ 10 ], but we have shown that it alone is less accurate than NFE in predicting the rate of adenoidal obstruction in children with perceived obstructed nasal breathing or recurrent/chronic middle ear disease, and should therefore be abandoned [ 7 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…This can be done by means of nasopharyngeal fiberendoscopy (NFE), a mirror examination with posterior rhinoscopy, a lateral neck roentgenogram, or a standardised clinical questionnaire [ 2 – 4 ]. However, NFE is the gold standard for assessing the volume and surface of the adenoids in children with suspected adenoidal disease [ 5 – 7 ] because it is minimally invasive and repeatable, does not expose patients to harmful ionising radiation, and allows direct inspection of the nasopharynx with complete visualisation of the adenoids, thus making it possible to grade hypertrophy and investigate possible choanal or ostial obstruction [ 5 ]. It is also a useful means of dynamically evaluating the entire nasal district, including the ostiomeatal complex and sphenoethmoidal recess, and investigating velopharyngeal closure during speech.…”

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices

et al. 2016

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BackgroundNasopharyngeal fiberendoscopy (NFE) is the gold standard diagnostic procedure for adenoidal disease, but there is no consensus concerning the optimal technical approach. The aim of this study was to investigate the attitudes of Italian otolaryngologists towards diagnostic NFE in children, and the most widely used methods.MethodsNine hundred randomly selected members of the two largest Italian otolaryngological scientific societies were e-mailed an anonymous web-based questionnaire containing 29 multiple-choice items regarding their opinions about, and use of NFE in children.ResultsQuestionnaires were returned by 764 clinicians (84.9 %). About 75 % declared they used NFE, but 35 % said they preferred alternative diagnostic methods. Most of the respondents considered NFE safe, but more than 80 % judged it to be poorly or only fairly well tolerated. Almost all declared that they generally use flexible, small-diameter instruments, with the patient seated on a chair or a parent’s lap; 65 % use gentle restraining methods. Fewer than 50 % reported using a standardised hypertrophy grading system.ConclusionItalian otolaryngologists have a generally positive attitude towards using NFE in children. However, some have reservations, and there was no unanimous agreement concerning how it should be done. Given the medical advantages of NFE, it is essential to clarify the many still controversial aspects of the procedure by means of comparative studies and educational programmes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices

et al. 2016

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“…8 Contradictory to this study, Torretta and Marchisio concluded that nasal obstruction index (NOI) cannot be utilised in assessment of adenoid hypertrophy. 9 Hence in our study we included other clinical symptoms scoring along with NOI in determining the usefulness of the symptom score in evaluation of the responsiveness to mometasone nasal spray.…”

Section: Nasal Obstruction Indexmentioning

confidence: 99%

Role of mometasone furoate nasal spray in children with adenoid hypertrophy: impact on life style changes

Venkatesha

Shekhar

2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Adenoid hypertrophy (AH) is a common cause of upper airway obstruction and obstructive sleep apnea syndrome (OSAS) in children having major impact on child’s growth and development. Symptoms like nasal congestion, mouth breathing, nasal discharge, snoring, day time sleepiness, hyponasal voice, ear popping, and craniofacial abnormalities are observed. Adenoidectomy is considered the treatment of choice for symptomatic children. Co-existing medical illnesses and choice of surgical treatment is governed by the paediatricians and apprehensive parents. Need for conservative treatments in alleviating symptoms have been tried. Topical, intranasal administered, steroid preparations have been proven effective in the literature.Methods: In this prospective study, 35 symptomatic children (3-12 years) with adenoid hypertrophy were included. Each of the symptoms was scored from 0 (absent) to 4 (severe) over Visual Analogue Scale (VAS). Nasal obstruction index was calculated. Results of mometasone furoate nasal spray 100 microgram/day used once daily at the interval of 8 weeks and 12 weeks were analysed using statistical tests. Results: A statistically significant reduction in nasal obstruction index and other symptoms were noted at the end of third month follow up.Conclusions: Mometasone furoate nasal spray caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, ear symptoms and overall quality of life.

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“…For this reason, nasal endoscopy is preferred, and more reliable, fiberoptic nasopharyngeal endoscopy can be easily performed by any pediatric ear–nose–throat (ENT) service with minimal patient discomfort and allows a good evaluation of septal, turbinate, or meatal abnormalities. These areas (middle turbinate and middle meatus) should be inspected carefully concerning the quality, quantity, and site of secretions (e.g., purulence originating from the osteomeatal complex), the presence of inflammation (mucus, edema of middle meatus or ethmoid area), and the choanae, nasopharynx, eustachian tube ostium, and soft palate (18).…”

Section: Background For Management Of Crsmentioning

confidence: 99%

Management of chronic rhinosinusitis

Cazzavillan

Castelnuovo

Berlucchi

et al. 2012

Pediatric Allergy Immunology

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: Chronic rhinosinusitis (CRS) in children is difficult to treat, with resultant frequent recurrences and failures. There are controversies in the treatment, mirroring the debate over the exact etiology of this disorder. The available medical treatments are antibiotics, topical nasal corticosteroids, and nasal lavage with saline solutions; though, there is no general agreement on the efficacy of the latter. The new technique of balloon sinuplasty allows ventilation to the sinuses to be restored with minimal risk and trauma to the tissues, and initial outcome seems promising, being successful in most treated children. Concerning the surgical approach, adenoidectomy is among the most frequent surgical procedures performed on children, but its therapeutic effect is controversial, because randomized studies have failed to prove that adenoidectomy alone is sufficient in curing CRS. Instead, functional endoscopic sinus surgery is a minimally invasive technique which restores the sinus ostia patency and can re-establish ventilation and drainage through the natural pathways. It is important that the effectiveness of any treatment is also evaluated by patient-reported outcomes (PROs) that refer to all health-related reports coming from the patients, without any involvement or interpretations by physician or others. Among PROs, health-related quality of life (HRQL) is the one most widely known and used. HRQL can be measured by means of validated questionnaires, which provide scores proportional to the degree of well-being perceived by patients. Concerning diseases of the upper airway including RS, there are numerous instruments specifically designed for children and caregivers, which allow to assess the effects of treatments in a more extensive and complete manner.

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Diagnostic accuracy of the nasal obstruction index in detecting adenoid hypertrophy in children without allergy

Cited by 19 publications

References 14 publications

Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices

Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices

Role of mometasone furoate nasal spray in children with adenoid hypertrophy: impact on life style changes

Management of chronic rhinosinusitis

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